Lots of bean counters spoke here. Bottom line is that many patients in the US have poorer outcomes than in other countries because they just don't have healthy lifestyles. BTW, my goal here is just to spit out little factoids, not write some profound, grammatically perfect diary. As a health care provider, I feel that outcome ratings of doctors can be extremely inaccurate and I'lll give you an example. A patient is admitted for same day surgery for a laparoscopic procedure and goes home uneventfully. He is re-admitted 5 days later with a wound dehiscence. The doctor is dinged for a re-admission even though the patient was a diabetic, poorly controlled due to bad dietary habits, and smokes a pack and half a day.
The above does not represent accurate data collection on the effectiveness of health care providers. There are many more such scenarios that are very analogous.
Lastly, the panel members on this CSPAA edition are often massively overpaid bureaucrats getting insane salaries, like the 9-10 million per year that BCBS guys like Andrew Dreyfus make. In the context of saving health care dollars, it's ludicrous. I don't buy the justifications for present and past salaries of health care insurers CEO's.
So...a major goal for better health care would be people taking better responsibility for their health, higher minimum wage and paid sick hours so they can do this and afford to go to medical appointments, and a huge reduction in premiums for small businesses, unlike the crappy, massively high deductible, massive prescription copay policies that exist currently even with the ACA. Aside from more access to Medicaid, the premiums for small business owners have NOT gotten better.. We have our work cut out to get more affordable health care and reduce waste.